Pharmaceutical care program for patients with uncontrolled hypertension : report of a double-blind clinical trial with ambulatory blood pressure monitoring

• Published in: American journal of hypertension 2006-05, Vol.19 (5), p.528-533
• Main Authors: DE CASTRO, Mauro Silveira, FUCHS, Flavio Danni, SANTOS, Melissa Costa, MAXIMILIANO, Paulo, GUS, Miguel, MOREIRA, Leila Beltrami, FERREIRA, Maria Beatriz Cardoso
• Format: Article
• Language: English
• Subjects: Antihypertensive Agents - therapeutic use; Arterial hypertension. Arterial hypotension; Biological and medical sciences; Blood and lymphatic vessels; Blood Pressure - drug effects; Blood Pressure - physiology; Blood Pressure Monitoring, Ambulatory; Cardiology. Vascular system; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; Double-Blind Method; Female; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; Hemodynamics. Rheology; Humans; Hypertension - drug therapy; Hypertension - physiopathology; Male; Medical sciences; Middle Aged; Pharmaceutical Services - organization & administration; Program Evaluation; Severity of Illness Index; Treatment Outcome; Vertebrates: cardiovascular system
• ISSN: 0895-7061; 1879-1905
• DOI: 10.1016/j.amjhyper.2005.11.009

Pharmaceutical care programs may be an option to improve blood pressure (BP) control in patients with uncontrolled hypertension. The aim of this study was to evaluate the efficacy of pharmaceutical care programs in treating patients with resistant hypertension. In a double-blind randomized clinical trial, 71 patients with uncontrolled BP were enrolled in a pharmaceutical care program or in a control group and underwent a series of cognitive tests. The primary outcome was change in ambulatory BP (ABP) between the baseline evaluation and the final visit 6 months later. The secondary outcomes were the frequency of drug-related problems and adherence as determined by plasma levels of hydrochlorothiazide. The delta-values between the intervention and control groups for ABP in the different daily periods, with the corresponding 95% confidence limits, adjusted for age and baseline BP were: 3 (-1 to 5), 2 (-2 to 4), and 5 (-1 to 6) mm Hg for 24 h, daily and nightly systolic BP, respectively. The corresponding values for diastolic BP were 1 (-1 to 3), 0 (-2 to 2), and 3 (-1 to 4) mm Hg, respectively. Hydrochlorothiazide was detected in the plasma in 21 of 27 patients in the intervention group that attended to all appointments and 24 of 30 patients in the control group (P = .904). The pharmaceutical care program tested in this trial was feasible and showed a trend for better BP control in patients with uncontrolled hypertension.